============================================================================== CERTIFICATE OF NEED INTELLIGENCE BRIEF: MARYLAND The Rojas Report | conlaws.rojasreport.com/states/maryland/ ============================================================================== State: Maryland (MD) Score: 95/100 Tier: Most Restrictive Rank: 41 of 51 jurisdictions ------------------------------------------------------------------------------ SUMMARY ------------------------------------------------------------------------------ In-depth analysis of Maryland\\'s highly restrictive Certificate of Need (CON) laws, market concentration, and the impact on healthcare access and cost. ------------------------------------------------------------------------------ APPLICATION PROCESS ------------------------------------------------------------------------------ 90 days (standard) to 150 days (with hearing) Our investigation found no publicly documented instances of the Maryland Health Care Commission formally denying a Certificate of Need application. While approvals are noted in reports, specific details on denied projects, withdrawn applications under pressure, or legal challenges are not made available. This lack of transparency makes it impossible to quantify the full chilling effect of the law on potential healthcare innovators and the patients they would serve. ------------------------------------------------------------------------------ MARKET CONCENTRATION ------------------------------------------------------------------------------ Sources: Maryland statutes and regulations; Maryland Health Care Commission reports; academic and policy analyses; press releases and health system data. ------------------------------------------------------------------------------ REFORM STATUS ------------------------------------------------------------------------------ ~$9.0 Billion Revenue (FY25) ~$8.7 Billion Revenue (FY23) ------------------------------------------------------------------------------ CASE LAW / DENIALS ------------------------------------------------------------------------------ No Public Record of Denials Our investigation found no publicly documented instances of the Maryland Health Care Commission formally denying a Certificate of Need application. While approvals are noted in reports, specific details on denied projects, withdrawn applications under pressure, or legal challenges are not made available. This lack of transparency makes it impossible to quantify the full chilling effect of the law on potential healthcare innovators and the patients they would serve. ============================================================================== Source: The Rojas Report | conlaws.rojasreport.com/states/maryland/ Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments Generated: April 2026 ==============================================================================